N1130 Self-Concept

Self-concept (slide definition)

Mental image one has of oneself. Subjective, may be falsely positive or negative. Develops within a context and by interaction with others. Includes our deep core beliefs about ourselves.

Self-concept (Mallette & Yonge)

The totality of each person's beliefs about their inner self. An integration of cultural heritage, environment, gender roles, ethnic and racial identity, spiritual beliefs and values, upbringing, education, basic personality traits and cumulative life experiences.

Our many selves

Private self: what you keep personal. Perceived self: how you see yourself. Public self: the version of you others see. Presenting self: how you deliberately show yourself to others. (Adler, 2016)

4 components of self-concept

Personal identity, body image, role performance, self-esteem.

Personal identity

An internal sense of individuality, wholeness and consistency of a person over time and in various circumstances. Values, beliefs and characteristics that make a person unique. Has multiple dimensions (spiritual, cultural, gender); includes gender identity, gender expression and sexual orientation; influenced by cultural and societal norms.

Body image

Thoughts and feelings about one's body/appearance: perception of physical appearance and function. May not match actual appearance (e.g. distorted). Influenced by societal/cultural values (including media) and changes in appearance or function (growth and development, injury).

Role performance

One's perceived ability to carry out significant roles. Ask: are expectations of own performance within one's roles realistic and attainable?

Self-esteem

One's evaluation of one's self-worth. Enhanced when one feels capable, worthwhile and competent (Rosenberg). Related to happiness and closely linked to self-efficacy. Beware social myths of "perfection".

3 things that shape development of self-concept

1) Social environment (incl. parenting style/attachment) 2) Reflected appraisal and social comparison 3) Erikson's developmental theory

Social environment and parenting style

Self-concept isn't just born with; it develops through interaction and experience. Warm, consistent parenting supports self-esteem; harsh or inconsistent parenting can foster a negative self-concept (Bowlby's attachment theory).

Reflected appraisal

We develop our self-image partly from how we think other people see us (Cooley's "looking glass").

Social comparison

We judge ourselves against others.

Erikson's theory and self-concept

Sense of self develops throughout life in stages. Each stage has a psychosocial challenge, and how we work through it influences development.

Erikson's 8 stages (with age)

Trust vs mistrust (infant), Autonomy vs shame/doubt (toddler), Initiative vs guilt (preschool), Industry vs inferiority (school age), Identity vs role confusion (adolescent), Intimacy vs isolation (young adult), Generativity vs stagnation (middle adult), Integrity vs despair (older adult)

Factors influencing self-concept (9)

Developmental stage and maturity; family relationships and parenting style; culture and spiritual beliefs; peer acceptance and social support; educational and occupational success; trauma, abuse and bullying; chronic illness or disability; physical appearance and body changes; media and social comparisons.

Self-concept across the lifespan

Infants/toddlers: begin developing trust and autonomy. School-age: compare themselves to peers, develop competence. Adolescents: identity, body image, peer acceptance. Adults: role performance and achievements shape self-worth. Older adults: retirement, loss and health changes may challenge self-concept.

Self-concept stressor

Any real or perceived change that threatens identity, body image or role performance. It challenges a person's ability to adapt. The most important factor in the response is their perception of the stressor.

Crisis

Occurs when a person cannot overcome obstacles with their usual problem-solving and adaptation methods. Potentially threatens self-concept and self-esteem.

4 stressors affecting self-concept

Growth and development: physical, emotional, social changes with age. Life changes and transitions: e.g. retirement affects identity, confidence, roles. Illness: changes view of body, independence, abilities, future. Hospitalization: feeling vulnerable, dependent, loss of control.

Why does self-concept matter in nursing practice?

Affects almost all aspects of life and health: helps people make sense of past and present, communicate effectively, willingness to learn and perform tasks, ability to build healthy relationships. A strong sense of self protects when coping with chronic illness.

Self-concept as a filter

Our self-concept/self-esteem act as filters in interactions and may affect our ability to be sensitive to others' thoughts and feelings. For nurses and clients, self-concept influences response to stressors and illness.

Enhancing a client's self-concept (nurse strategies)

Active listening with a nonjudgemental, accepting attitude; a strengths-based approach (ask how they coped before); break tasks into small achievable steps (builds self-efficacy); involve family and social support.

Ways to enhance self-concept in self and others (slide)

Always do your best; self-compassion; positive self-talk (affirmations); small steps and realistic expectations; avoid comparing to others; reframe situations; surround yourself with positive influences; give/receive positive feedback; build skills (e.g. visual imagery); do something for someone else; seek professional support if needed.

Belief

Our understanding of reality: assumptions about what we believe to be true; accepted even without proof. Affects our morals and values.

Values

Principles or standards of behaviour considered valuable or important. Central to who we are, give meaning to our lives, and guide decisions about right and wrong.

Attitude

A mental position or feeling toward a person, object or idea (e.g. acceptance, compassion, openness). Often reflects likes and dislikes, good or bad.

Why reflect on personal beliefs, values and attitudes?

They are central to our concept of self. We all hold internalized beliefs and core values even if unaware. They underlie our choices, priorities, dreams and personal and professional goals.

Values clarification

Process of asking what is meaningful in our lives and which beliefs/values underlie our thoughts and behaviour. Helps us know what we want, set goals, make better choices and clarify values in conflict.

Perception

A process through which we interpret sensory information and turn sensory data into connected, personalized understanding (O'Brien, 2022).

Perception and personal meaning

All knowledge comes through perception, and perceptions influence the meaning people make of an experience. Interpretation is part of almost every interpersonal act.

Perception: key points

Same event can be perceived differently by different people. Physical and social perspectives and expectations influence selection and interpretation. Some misunderstandings come from differing perceptions. Clear communication, perception checking and feedback clarify them.

Perception checking (steps)

1) Describe the behaviour/scene (what did you see, hear, smell? the facts) 2) Consider possible interpretations / what influenced yours / other explanations 3) Request clarification (if another person is involved) Cooperative approach; signals respect and concern.

Perception checking example

"You haven't eaten any breakfast" (behaviour/fact). "I wonder if you prefer other food choices or aren't hungry" (possible interpretations). "What is happening?" (request for clarification).

Why we need perception checking (5 tendencies)

We evaluate ourselves more leniently than others; are influenced by expectations; are influenced by the obvious; stick to first impressions; assume others are similar to us (Adler et al.).

Barriers to gender-affirming care (PHSA Trans Care BC)

Lack of access to experienced gender-affirming providers; care withheld due to misconceptions about guidelines; lack of accessible facilities and administrative processes; discrimination and refusal of care.

Gender-affirming care is...

Client-centred, flexible, accessible, non-judgemental, trauma informed, and based on informed consent. Uses correct nouns/pronouns and gender-inclusive language.

Support and gender diverse health outcomes

Supportive families and service providers are especially important. Also: support networks, physical and social environments, education and employment, access to health care.